Innovative Programs by Geisinger Health and Kaiser Permanente Are Moving Providers in Unexplored Directions in Support of Proactive Clinical Care

These initiatives are
a call-to-action for clinical laboratories to contribute their expertise in
support of wellness programs

Two of the largest healthcare systems in America are moving
in non-traditional directions to proactively address certain healthcare
populations. Most recently, Kaiser
Permanente announced it will be investing millions of dollars to tackle
homelessness and the disease outbreaks associated with it. The health system is
even investing in a housing complex in Oakland, Calif., which it hopes will help
patients in that area who face housing insecurity.

Kaiser’s new direction mirrors a similar project by Geisinger Health designed to address the
health of certain populations. In 2017, Geisinger launched what it calls the “Fresh Food Farmacy” for
its adult diabetic and obese patients to give them access to healthy foods. Geisinger
finds this service saves substantial money in downstream medical expenses
because the patients are healthier.

If these programs are harbingers of things to come, clinical
laboratories open to supporting such wellness programs will find
opportunities heading their way.

The housing complex consists of 41-units and is in an area
where existing residents are at risk of displacement due to gentrification.
Kaiser Permanente’s purchase means the complex will be blocked from
redevelopment and will remain affordable for the residents who live there.

“Housing security is a crucial health issue for vulnerable
populations,” Bernard
Tyson, Chairman and CEO at Kaiser Permanente, stated in a news
release. “Access to affordable housing is a key component to Kaiser
Permanente’s mission to improve the health of our members and the communities
we serve.”

This unusual move is part of a larger strategy to invest in
the economic, social, and environmental conditions that impact the health of Kaiser’s
patients. It’s also part of a greater trend toward value-based, proactive
healthcare.

“We know that differences in health are striking in communities with poor social determinants of health such as unstable housing, low income, and unsafe neighborhoods,” said Richard Isaacs, MD, CEO and Executive Director of The Permanente Medical Group, in the news release. “These innovative strategies are critically important steps toward the maintenance of health improvement, consistent health outcomes, and California health equity.” (Photo copyright: Kaiser Permanente.)

Proactive versus Reactive Care

Healthcare delivery in the US is transitioning from
volume-based to value-based care. The Kaiser and Geisinger projects are championing
another equally critical change—proactive care instead of reactive care. This
shift in priorities promises to change how health systems and healthcare
providers think about healthcare delivery. And clinical pathology laboratories play
a critical role in these changes.

“Specifically, in the transition from volume-based to
value-based healthcare, clinical laboratories are called upon to provide
programmatic leadership in reducing total cost of care through optimization of
time-to-diagnosis and time-to-effective therapeutics, optimization of care
coordination, and programmatic support of wellness care, screening, and
monitoring. This call to action is more than working with industry stakeholders
on the basis of our expertise; it is providing leadership in creating the
programs that accomplish these objectives,” James M. Crawford,
MD, PhD, and co-authors, noted in their paper, “Improving American
Healthcare Through Clinical Lab 2.0: Santa Fe Report,” published in the journal
Academic
Pathology.

Food as a Prescription

Patients encounter all sorts of challenges in addition to
housing. Geisinger Health’s Fresh Food Farmacy program promises to help obese
and diabetic patients who face food insecurity maintain healthy diets. Coupled
with exercise, the program acts like medication in helping regulate blood sugar
and improving long-term outcomes for people with diabetes.

Patients in the program are given a referral, called a
prescription, by their primary care physician. Once enrolled, they receive a
welcome kit that includes food measurement instruments, recipes, and
nutritional information. Each week, they also receive enough food to prepare
healthy, nutritious meals twice a day for five days for their families.

Enrolled patients attend weekly support groups to learn
about self-management. And they complete an online wellness class to help them
learn about nutrition. The program also offers free cooking and nutrition
classes taught by dieticians and health coaches.

Proactive, Value-Based Care and Population Health

“With what’s happening in this nation right now, there’s
never been a more important time for us to focus in on this population and to
do that through a united front,” Lloyd Dean, CEO at CommonSpirit Health (formerly known as
Dignity Health), told Forbes.

The housing program at Kaiser Permanente and the Fresh Food
Farmacy at Geisinger are just two of the latest examples that healthcare
providers are increasingly focusing on population health. The fee-for-service model
of healthcare pays health systems, hospitals, and other providers, based on the
number of sick they treat. These new programs, however, move the entire
healthcare system toward keeping people from getting sick in the first place.

“I think there’s no doubt that we need to emphasize both
health needs and social service needs, and we should be thinking about these
collectively and not in silos,” Signe
Peterson Flieger, PhD, Assistant Professor of Public Health and Community
Medicine at Tufts University, told Forbes.

As progressive health networks such as Kaiser Permanente and
Geisinger move the traditional sites and types of medical care into new
settings and new directions, medical laboratory managers and personnel need to
stay alert for opportunities to support innovative, new health and wellness
programs in their communities.